We don’t all face the same risk for cancer. Nor do we all receive the latest treatments. Many communities and minority populations experience health disparities, ranging from unequal access to cancer screenings and increased barriers to care to higher rates of late diagnoses and a reduced quality of life. For instance, in the United States, the cancer mortality rate is 19% higher for African-American men than for white men. Health equity advocates aim to address such imbalances, whether they are a result of race and ethnicity, gender, socioeconomic status, sexuality, geography (living in rural areas), education, language or some other factor.
“Health equity means everyone has a fair and just opportunity to prevent, find, treat and survive cancer,” explains the American Cancer Society Cancer Action Network, adding a caveat: “Equity is not the same as equality. Equality is providing everyone with the same tools and resources. Equity is providing tools and resources based on needs that allow everyone the opportunity to be as healthy as possible.” For instance, does health information need to be presented in Korean or in a manner that’s culturally sensitive? Do some clients require transportation or internet access? Do patients see themselves reflected in their health care staff?
Our fourth annual Cancer Health 25 honors individuals working tirelessly to define and address such disparities. They include doctors, nurses, researchers, volunteers, patient navigators, grassroots advocates and a world leader. This year, some entries even include more than one person. All are champions of health equity.
Maura Abbott, Amy McElroy and Kristin O’ Meara
New York, New York
ColumbiaDoctors and the Columbia School of Nursing launched a clinical outreach program in 2022 to provide cancer screenings and other essential health services to residents of Washington Heights and neighboring New York City communities, many of whom are underserved minorities. The outreach program, which includes on-site events and school health days, is led by Maura Abbott, PhD, an oncology nurse practitioner and the assistant dean of clinical affairs at the Columbia School of Nursing; Amy McElroy, MPH, RN, ColumbiaDoctors’ director of population health; and Kristin O’Meara, ColumbiaDoctors’ director of strategic communications. What began as a series of skin screenings and educational events for the communities has evolved into a multidisciplinary array of offerings, including eye exams, flu shots, mammograms, prostate cancer screenings and more.
Karlie Allen, Nathan Begaye and Liliana Mulato
Salt Lake City, Utah
The Intermountain West region—Utah, Idaho, Montana, Nevada and Wyoming—spans a vast area and includes disparate communities, such as American Indian, Latino and rural populations, whose unique needs are met by the patient navigators at the University of Utah’s Huntsman Cancer Institute. These include program leaders Nathan Begaye and Liliana Mulato and adolescent and young adult patient navigator Karlie Allen as well as recently added navigators Amelia Thelin, Mariela Sanchez and Naomi Guerrero Reyes. Together, they break down barriers their clients face—for example, by speaking Spanish. They also expand clients’ access to clinical trials and the latest cancer treatments.
President Joe Biden
As vice president in 2016, Joe Biden launched the federal Cancer Moonshot initiative. As president, he supercharged the program that aims “to cut the cancer death rate in half in the next 25 years [and] end cancer as we know it.” In support of the initiative, the National Cancer Institute unveiled a National Cancer Plan that sets eight goals, one of which is to “eliminate disparities in cancer risk factors, incidence, treatment side effects and mortality.” Biden lost a son to brain cancer: Major Beau Biden was stationed overseas where he was exposed to hazardous burn pit emissions, known to be carcinogenic. Last year, Biden championed and signed the PACT Act, legislation that improves health care and benefits for veterans—many from minority and underprivileged communities—who were exposed to toxic and cancer-causing substances.
Evelinn A. Borrayo
Fort Collins, Colorado
A deep commitment to the elimination of cancer disparities affecting underserved communities motivates Evelinn Borrayo, PhD, a professor at the Colorado School of Public Health and the associate director of its Latino Research and Policy Center. She applies behavioral science to address disparities in cancer prevention, control and survivorship among racial and ethnic minorities and other medically underserved populations. Past research has examined the psychological, cultural and social factors affecting the prevention and treatment of lung and head and neck cancers among Latinas and Latinos. She works in Colorado communities with poor cancer outcomes to identify barriers and help remove them person by person.
Yee Won Chong and Brooks Nelson
Yee Won Chong and Brooks Nelson are transmasculine friends and housemates who were diagnosed with breast and ovarian cancer, respectively, within days of each other. In 2018, they made the short film Trans Dudes With Lady Cancer to raise awareness, educate providers and support others like themselves. Trans people need cancer screenings based on the organs they possess, but many lack regular access to health care or find existing services unwelcoming. Nelson, an experienced filmmaker, also made a documentary exploring how gender transition affects trans people’s loved ones and communities. Chong, an immigrant from Malaysia, provides transgender inclusion trainings to colleges and workplaces and developed the “Say This Not That” technology platform to promote inclusive language.
Charleston, South Carolina
In 2012, Cora Connor’s brother Herman discovered he had renal medullary carcinoma (RMC), a rare form of kidney cancer that primarily affects young African-American men who carry the sickle cell trait. Seeing the limited treatment options available to Herman, Connor founded R.M.C. Inc. to advocate for her brother, educate the public and health care professionals and enhance the lives of others affected by RMC. She has lobbied for health care legislation in South Carolina to educate young people about the cancer risks associated with sickle cell disease, and she urges young Black people with sickle cell disease to get tested for RMC.
Julie HT Dang
A cancer health disparities behavioral scientist, Julie HT Dang, PhD, MPH, works to ensure that diverse and underserved populations have access to cancer prevention and intervention tailored to their culture and community. She’s an assistant professor and executive director for the Office of Community Outreach and Engagement at the University of California, Davis Comprehensive Cancer Center, where her research and programs boost Asian-American participation in cancer research and clinical trials and promote testing for hepatitis B, which can lead to liver cancer. Her work also encourages more young people and those in rural areas to get vaccinated against human papillomavirus (HPV), another cause of cancer. Her other areas of expertise include breast and colorectal screenings for Black, Latino and Native American communities.
American Indian and Alaska Native populations experience higher mortality and incidence rates for lung, breast, colorectal, kidney and liver cancers compared with non-Hispanic white populations. These disparities result, in part, from limited access to screening and prevention services. Craig Dee, an MPH candidate and member of the Navajo Nation (Diné), aims to change that. Dee leads the Indigenous Cancer Health Equity Initiative within the Office of Community Outreach & Engagement at the Fred Hutch/University of Washington/Seattle Children’s Cancer Consortium. He centers relationality, an Indigenous value, in his work to build research capacity and cultivate partnerships with tribes, the Indian Health Service and Urban Indian Organizations. “Indigenous people,” he says, “have always been involved in public health. We look out for the community.”
Loretta Erhunmwunsee and Terrance Mayes
Duarte, California, and Stanford, California
When the National Comprehensive Cancer Network launched the Diversity, Equity, & Inclusion Directors Forum last year, it tapped Terrance Mayes, EdD, the executive director and associate dean of strategic initiatives at the Stanford School of Medicine, to chair the forum and Loretta Erhunmwunsee, MD, of City of Hope National Medical Center, to serve as vice chair. With over 20 expert members, the forum meets to share challenges and best practices to improve the diversity of clinical staff. A thoracic surgeon with a focus on lung and esophageal cancer, Erhunmwunsee is also a health equity researcher who explores how social determinants and structural inequities impact cancer biology and outcomes. “In order to achieve cancer health equity,” she says, “cancer centers must identify and eliminate structural barriers and practices that undermine workforce diversity, equity and inclusion.”
Los Angeles, California
Two-time cancer survivor David Ford is passionate about cancer screenings. Ignoring his doctor’s advice to get a colonoscopy in 2014 landed him in the hospital three months later with a ruptured intestine because of colon cancer. Surgery saved his life. Three years later, prompt attention to his doctor’s advice after an elevated PSA test led to a diagnosis of early-stage prostate cancer that was treated successfully with radiation. As a member of the board of directors for the American Cancer Society’s Cancer Advocacy Network, Ford works tirelessly to expand awareness and access to cancer screenings, especially in communities of color.
Lake Worth, Florida
The Cancer Equity Project is an awareness and educational campaign that was launched earlier this year by Total Health, which provides free oncology continuing medical education. Helping lead this new effort is breast cancer survivor Sharon Gill, the head of partnerships and advocacy Programs at Total Health. The Cancer Equity Project has already launched the EBONY-B001 clinical trial for young Black women with high-risk breast cancer, and it established the SEEK Color Certificate Program to encourage cancer care teams to further their education in order to better serve patients of color. “My goal,” Gill says, “is to positively impact the cancer landscape for underrepresented communities so that everyone receives equitable care and treatment.”
Bucks County, Pennsylvania
CancerCare CEO Patricia Goldsmith says her passion for patient advocacy stems from when she was 19 and lost her only sibling, who was 22, to a brain tumor. Founded in 1944, CancerCare offers free information and services—including support groups for African Americans, young people, LGBTQ folks and more—to help manage the emotional, practical and financial challenges of cancer. CancerCare’s tool kit for employers helps remove barriers to insurance coverage for cancer treatment, including biomarker testing. Goldsmith, who describes herself as an “avid animal rescuer,” started CancerCare’s Pet Assistance and Wellness Program, which helps cancer patients keep and care for their pets.
Charlie W. Hill
Known as a prostate cancer warrior (who also battled follicular lymphoma) and a tireless volunteer, Charlie W. Hill cofounded the Hampton Roads Prostate Health Forum in 2007, a nonprofit that raises awareness and provides education to communities in his region of Virginia, with a special focus on men of African descent and what he calls “pre-hab”—activities that optimize health and reduce disability before and after a cancer diagnosis. He’s also active with ZERO Prostate Cancer Run/Walk events. Earlier this year, the American Cancer Society honored him with the Fredda Bryan National Diversity, Equity, and Inclusion Award.
An oncologist and the chief clinical access and equity officer at the Dana-Farber Cancer Institute, Chris Lathan, MD, MPH, researches the effects of race—including racial disparities in lung cancer treatment—class and access to care on cancer outcomes. Lathan is a founding director of the Cancer Care Equity Program at Dana-Farber, an outreach program that provides cancer diagnostic services directly to underserved Black communities. The program, which has been operating for 12 years, has reduced the time it takes to diagnose cancer from an average of 32 days to just 12 days.
With 30 years of experience in health care and community relations, Kathy Levy works to ensure that all people have equitable access to lung cancer care. As project manager of Alabama Lung Cancer Awareness, Screening and Education (ALCASE) through GO2 for Lung Cancer, Levy helps educate people with lung cancer in seven counties in Alabama. For her activism focused on increasing access to lung cancer screening, Levy was a finalist for the prestigious C2 Catalyst for Equity award, which recognizes people who work to overcome racial and ethnic disparities in cancer care.
In December 2018, while dressing for a holiday party, Keneene Lewis, MEd., found a lump on her breast; it turned out to be Stage III ductal carcinoma, an aggressive type of breast cancer. As a Black woman, she witnessed racial bias firsthand when, believing that Black women don’t feel pain the same as other women, a radiation technician withheld pain-numbing cream. As a single mom, she experienced financial distress. Now, Lewis is giving back. An active blogger, she is an administrator for Living Beyond Breast Cancer, managing grants so women undergoing treatment can pay for vital expenses, such as rent. She is currently in remission.
“I am a family doctor but also a cancer researcher,” explains Li Li, MD, PhD, MPH, who chairs the Department of Family Medicine at the University of Virginia’s School of Medicine. “My research really tries to understand the disparities between Black and white [population groups] in terms of risk and survival of colon cancer.” Specifically, he explores “how our environment works together with the genome to drive the colon cancer carcinogenesis.” Li has received grants from the Damon Runyon Cancer Research Foundation and others and serves on numerous organizations that focus on cancer prevention and population health, including the U.S. Preventive Services Task Force.
Javier Macias and Laura Ortiz-Ravick
Chicago, Illinois, and White Plains, New York
Serving Spanish-speaking families impacted by blood cancers, Javier Macias and Laura Ortiz-Ravick provide educational opportunities and resources that help Spanish speakers make informed decisions about care and treatment. Working alongside the Leukemia & Lymphoma Society (LLS) team, Ortiz-Ravick and Macias have educated over 600 Promotores de Salud (health promoters) and other Spanish-speaking community health workers nationally about blood cancers and have reached over 200,000 Latino individuals in the last two years through grassroots community outreach efforts. They also partner with national and local stakeholders to enhance trust between LLS and vulnerable segments of this population. In addition, Ortiz-Ravick works with LLS’s Myeloma Link initiative to help raise awareness of this cancer’s prevalence in the African-American community.
Folasade P. May
Los Angeles, California
In her May Laboratory at UCLA, Folasade (Fola) May, MD, PhD, a gastroenterologist and associate professor of medicine at the David Geffen School of Medicine, seeks to eliminate health disparities in colorectal cancer screening and care among Black and other underserved populations. With funding from the National Institutes of Health, the American Cancer Society, Stand Up To Cancer (SU2C) and others, she has designed and executed multiple studies to examine the impact of patient, provider and system factors on colorectal cancer, obesity, chronic liver disease and liver cancer. She raises public awareness about preventive health as she advocates for policies to improve health care delivery and health equity.
Joanna Fawzy Morales
Park Ridge, Illinois
Cancer rights attorney Joanna Fawzy Morales, Esq., has spent nearly 30 years advocating for people with cancer and their caregivers. The cofounder and CEO of Triage Center, a national nonprofit that provides free education on cancer--related legal and practical matters, Morales has led nearly 1,000 seminars on these issues as well as legislative advocacy. She has also won several awards, including the 2009 Susan G. Komen for the Cure Public Policy Advocate of the Year. She has taught law and coauthored Cancer Rights Law: An Interdisciplinary Approach for the American Bar Association.
Palo Alto, California
One day soon, smartphones and telehealth programs, using artificial intelligence to scan image datasets, may help dermatologists and primary care doctors identify melanoma and other skin cancers. But datasets based on light-colored skin miss some malignancies in people of color. Dermatologist and dermatopathologist Roberto Novoa, MD, an associate professor at the Stanford School of Medicine, is working to change that. He is part of a team of researchers funded by L’Oréal Dermatological Beauty Brands and the Melanoma Research Alliance that created the first publicly available dataset that includes biopsy-proven malignancies in people of color, which should improve diagnosis of skin cancer in diverse populations.
Edith A. Perez
San Francisco, California
Edith A. Perez, MD, the chief medical officer of Bolt Biotherapeutics and a professor emeritus at the Mayo Clinic, has spearheaded numerous efforts to improve representation in clinical trials and access to the latest treatments. An internationally recognized translational researcher and breast cancer guru, Perez is the chair of the Stand Up To Cancer (SU2C) Health Equity Committee, vice chairperson of the SU2C Scientific Advisory Committee and a cofounder of the DONNA Marathon, a fundraiser for breast cancer research and support for patients and families in need of financial and health care navigation assistance. You may recognize her from SU2C’s recent public service announcements promoting the importance of funding groundbreaking cancer research.
Kim F. Rhoads
San Francisco, California
A former surgeon, Kim F. Rhoads, MD, MPH, is an associate professor of epidemiology and biostatistics at the University of California, San Francisco (UCSF) and the associate director of community outreach and engagement at the UCSF Cancer Center. Her research covers the cancer spectrum while addressing disparities and amplifying community voices. To further boost those efforts, she founded the community health nonprofit Umoja Health. “I am passionate about advancing health equity and working at the intersection between health care and public health,” says Rhoads, who also has a background in community organizing.
Cervical cancer screening saves lives. To that end, Kathleen Schmeler, MD, a professor of gynecologic oncology and reproductive medicine at MD Anderson Cancer Center, developed programs that offer free Pap and HPV tests to women in underserved communities—the Rio Grande Valley in Texas, and Mozambique—as well as care for those with abnormal results. At MD Anderson, she works with collaborative international efforts to reduce the burden of women’s cancers, including cervical and breast cancer, and is executive director of the Global Oncology Program, which aims to reduce the global cancer burden in low- and middle-income countries, including a model initiative in Indonesia.
Cancer survivors frequently experience medical financial hardship, which is associated with increased mortality. So concludes one of the 250 papers coauthored by Robin Yabroff, PhD, MBA, scientific vice president for health services research at the American Cancer Society. She leads a research team examining ways to lessen this burden, including reducing the cost of drugs and improving access to transportation and insurance. She aims to identify factors at every level of care that can be modified to improve access to affordable prevention, screening, treatment, survivorship and end-of-life care to achieve equity in cancer outcomes.